A strengths-based resilience intervention for first-year nursing students: A mixed-methods quasi-experimental...

Nursing students are highly vulnerable to stress, anxiety, and mental health challenges, particularly during their transition into academic and clinical training. Strengths-based resilience interventions have been shown to enhance coping and well-being in student populations but are underexplored in non-Western nursing education contexts. Grounded in Self-Determination Theory and social ecological theory, this study aimed to examine the short-term outcomes of the Changing Minds, Changing Lives (CMCL) strengths-based resilience program among first-year nursing students in a non-Western context.

This mixed-methods quasi-experimental study included 53 first-year nursing students allocated to intervention (n = 27) or comparison (n = 26) groups according to their existing class sections; one section was assigned to each condition. The intervention group received a 10-session strengths-based resilience program over five weeks. Quantitative outcomes were measured pre- and post-intervention using validated instruments: the Thai Perceived Stress Scale (T-PSS-10), Thai Connor-Davidson Resilience Scale (CD-RISC-25), Emotional Self-Awareness Scale (ESA), and Perceived Cohesion Questionnaire (PCQ). Outcomes were assessed immediately before and after the five-week program; no longer-term follow-up was conducted. Repeated-measures MANOVA with post hoc Bonferroni tests assessed group and time effects, and analyses of covariance adjusting for baseline scores were conducted as sensitivity analyses. Qualitative data were collected via reflective writings and final presentations and analyzed using conventional content analysis.

The groups were not equivalent at baseline: the intervention group reported higher perceived stress and lower resilience. Significant group × time interaction effects were found across all four outcomes, indicating that resilience, emotional self-awareness, and perceived university belonging increased, and perceived stress decreased, to a significantly greater degree in the intervention group than in the comparison group. Univariate interaction effect sizes were large (partial η² =0.15-0.40), and all effects remained statistically significant after adjustment for baseline scores. Qualitative findings revealed four themes: focus on strength, not weakness; sharing, listening, and learning from each other; understanding yourself and understanding others; and transformational learning.

Participation in the CMCL strengths-based resilience program was associated with short-term improvements in self-reported perceived stress, resilience, emotional self-awareness, and perceived university belonging. The translated and contextually adapted program was feasible to deliver within the first-year curriculum. Because allocation followed intact class sections, baseline differences were present, and no attention-matched comparison condition or longer-term follow-up was included, the findings should be regarded as preliminary.